“Oh, no!” my mother-in-law gasped when I started to stick some toothpicks into the plateful of hors d’oeuvres I was arranging. “Please don’t use those things. They’re terribly dangerous.”

Then she told me about the time she attended a party where lots of toothpick-bedecked finger food was served. A few days later, a fellow partygoer developed a bellyache so severe that it sent him to the ER.

X-rays revealed nothing. Doctors were mystified. Sadly, within a week the man developed a raging infection—and he died.

An autopsy revealed the tragic truth, my mother-in-law said. A toothpick had punctured his intestines, setting the stage for the fatal infection.

Does this sound like a one-in-a-billion freak occurrence? Admittedly, death by toothpick is rare—but it does happen, more often than many people (even doctors) may realize. In fact, I recently read a medical journal report that highlighted the dangers associated with the accidental ingestion of toothpicks and other small, sharp objects.

The problem is surprisingly difficult to diagnose—which is why you must be aware of the danger so you can protect yourself. What you need to know…


The journal article I read described a woman who had suffered—for months—from worsening stomach pain, weakness and loss of appetite. Her family physician was perplexed.

When the woman started spiking a fever and vomiting, she went to the emergency room, where doctors noted her racing pulse and disorientation. Then, within hours of arriving at the hospital, she developed respiratory distress, sepsis (blood poisoning) and multi-organ failure.

Suspecting an infection in her abdomen, doctors did an ultrasound scan and spotted what looked like an infected abscess (a collection of pus trapped inside tissue) on her liver. She was treated with IV antibiotics and had an operation to remove the infected tissue from her liver. That’s when the culprit—a wooden toothpick—was revealed.

Apparently, this woman had unknowingly swallowed the toothpick, which pierced her stomach before traveling to her liver. It then lodged in her liver tissue for months, eventually creating a life-threatening crisis.


It may seem strange that this woman’s family doctor didn’t know why she was getting so sick. But as the article authors pointed out, in most cases, finding a foreign object inside the body is a challenge. A wooden or plastic toothpick might not show up on a regular X-ray, and the symptoms such an object causes can easily be confused with those of other ailments.

This woman was lucky. A few weeks after her operation, she was as good as new.

But you would hate for the same thing to happen to you. So: Next time you’re eating an appetizer or sandwich that is held or held together by a toothpick, whether wooden or plastic, be sure to remove that spike before taking a bite…or nibble very carefully and chew slowly so that the toothpick doesn’t wind up being swallowed. Also be on the lookout for any broken bits of toothpick that might be lurking unseen in your food.

Other risky objects: Be equally cautious with similar small, sharp objects. For instance, never hold nails, sewing needles or straight pins between your lips—one could accidently slip down your throat. And be extra careful when eating chicken or fish so that you don’t swallow any bones.

What if you ever do develop unexplained abdominal pain that lingers? Ask your doctor to consider whether you might have swallowed something sharp and request an imaging test. Caution: An MRI could be dangerous if you swallowed something made of metal because the MRI’s powerful magnet could cause additional damage by making the object move around inside you or even ripping it from your body! So your best bet is probably an ultrasound and/or CT scan, which generally show more than an X-ray in such cases.